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This blog is about---You! Each and every post is about you. Use it to challenge your usual patterns, as a tool for self-discovery, to stimulate your thinking, to learn about yourself and to answer your questions about others.

Friday, December 16, 2011

The wrong way, at least in the opinion of most therapists, themselves. I have heard some pretty hot-under-the-collar declarations by therapists regarding what I am about to describe.
Most people, notably those who have never been in therapy before, seek a therapist in the following manner: "Hmmm, I think I will call my insurance company for a list of therapists that are on their panel. Oh, good, here's the list. Now, let me see, who has an office that is most conveniently located to my work or home."
This isn't how a therapist wants to be selected.
A therapist seeking their own consultant does it quite differently. (Yes, we do go to therapists ourselves and, by the way, you wouldn't want to see a therapist who didn't. Someone who already knows it all is not in a growth process). None of us would ever select a therapist for our own treatment or consultation using this method.

Why is that? It seems practical, efficient and logical. Well, because, this is a highly personal matter. It is even more personal than your relationship with your primary care physician. A therapist has to provide a number of things for you to be able to flourish in treatment: They need to match your idea of professionalism, be able to make you feel reasonably comfortable, seem intelligent and knowledgeable enough for your criteria. And that's just the beginning. It is a highly individual and personal selection that needs to be made.

It isn't that you are looking for someone perfect but, you are looking for someone with whom you can form a bond and with whom you can think: "I will probably be able to open up here. I can imagine myself being able to make the changes I need to make or look at the issues I need to, with this person." In other words, therapists are not interchangeable. Be willing to drive a little ways for the right person. It's worth it.

How Does the Therapist Think About You? You are probably more important than you realize. Most therapists in a solo private practice, do not have more than 20 cases at a time. They may have more than 20 people under their care as some cases may be couples or families. But, you can see, we are talking about a range of 10 to 30 people. So, you are not just a persona passing through. You receive a lot of attention from your therapist: Thought, care, planning, concern. You are individually considered;you are not in an assembly line.
When you start in therapy with a particular practitioner, they expect to see you on-going for awhile so, they begin by investing themselves in a relationship, in establishing a relationship with you. This relationship is important as it is the framework within which you will work on your problems.

So, How Do You Find This Just Right For You Person?
If you are lucky enough to get a personal referral, that is ideal. If you have a friend who is in or who has been in therapy and has someone to recommend, great. Ask around. Read profiles on referral services. If a therapist writes, read what they say; how does it make you feel? Investigate. Most therapists in their own practice now have some sort of on-line presence, a blog, a listing, a facebook page, a website; look at these and compare.
Once you've found a few that look interesting, it wouldn't hurt to do a little mini-phone interview.
The last time I sought a therapist for myself, I thought about what were my most important criteria---here I will share those with you---lots of experience, the older the better, someone who had lived a little---these were what I wanted.

I encourage you to think about what you want. And, also, what doesn't matter to you. For example, I didn't care if the office was the dingiest ever, if I found someone who could meet me at my level. But, for some people, the setting is important in feeling comfortable. I didn't care if the therapist was a man or a woman. This is important to some people. Etc. The point is to try to know what you are looking for---at least what your bottom line must-haves are.
Then I contacted a woman, out of my area, as a matter of fact, who had been the facilitator in some post-graduate training I did. So, she knew me a little which also helped. I asked her for recommendations, based on my criteria, outlined above. She gave me two suggestions. I picked one and it worked out great.

Using the 1st Discussed- Practical, Efficient Method
Once I had a parent come in with his son. His son had been seeing a therapist for quite awhile, was connected to her, had a bit of history with her, and felt comfortable with her. The parents' insurance through their employer had changed and the new one did not have the family's therapist listed. So, they were looking for a replacement, someone who was on their list and not too far from home.
The son looked so sad. I tried to say to them that they really should try to negotiate a fee with the former therapist, that the established relationship was important.
I guess you could say I was shooting myself in the foot by not just swooping them up---after all, new business for me, right? No. Not right. That's not only not ethical, it's unkind. The boy needed to complete the work he was doing with the therapist he knew. It was obvious to me.
Unfortunately, the father wouldn't hear of it. Why should he pay-in this case, the fee was $100. per session-when he could pay a co-payment of $35., he said emphatically. The last time I talked to them, they were still looking, looking for a replacement.

The Dilemma
Sometimes someone needs therapy, has insurance that will cover part of the cost, the insurance is an HMO (list of their own providers), and they can't afford standard fees.

On the other side is the therapist who earns their living on the payments they receive from a very few patients.

Compromise sometimes has to happen. Maybe the therapist can lower their fee a little and the patient can stretch their paying tolerance a little and a deal can be struck. Give it a try. I wish you the best in finding the therapist who is just right or, right enough, for you.

3 comments:

Yes, it's SUCH an important relationship - one of the most important ones we will ever have. Clients must feel right, they must feel comfortable. Most of my client's are set via Employee Assistance Providers (EAPs) and I guess they don't feel they have much choice. But I always emphasise that they DO have a choice and that they should give some thought to how comfortable they feel. If a client does't feel that they can work with me, I would not feel offended (although I would be interested to hear why they feel that way).

I have thought about seeing a therapist for a long time. Recently my life had become so unbearable that I knew I needed help. Unfortunately my last experience with counseling was forced on me after I attempted suicide in college. That was 14 years ago but I was worried that my thoughts would be too dark for a therapist. If I had to keep certain thoughts of suicide to myself, I knew there was no point but I was determined not to be involuntarily committed. For me, I needed a therapist to hear what I thought but still believe me when I said I could handle my thoughts. The therapist I have been talking to initially sent out police for welfare check when I missed first appointment. That was in March but recently I emailed him to apologize and he has spent the last few weeks making me feel comfortable by emailing me. I constantly told him he didn't have to keep in contact but he did. I was afraid that any therapist would want to bail on me so I kept pushing. Now I have my first appointment with him next week and am grateful. I never would have made appointment if not for his willingness to make me feel that I mattered. I know a therapist's time is valuable and yet he took the time and still takes the time. Of course therapist's can't spend their time reassuring a potential client just to come in but I needed the extra effort to feel it was okay to ask for help.

Anonymous, it sounds as if you have found a very conscientious therapist who is willing to go the extra mile for you. You might read some of the posts I've written on how you, as the patient, can do your part to make the therapy a success. It seems as if you have found the right person for you and I wish you well in that relationship and wellness for yourself.

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About Psychotherapy

"Counseling provides a special setting in which we can learn about ourselves. This can help us to be more effective in our relationships with others and with ourselves. It takes time, helpful observations and support to recognize and change our ways of living."Brooklyn College

The author of A Therapist's Thoughts is a therapist in full time private practice